Related Experiment Video
Updated: Feb 28, 2026
Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit
Published on: January 7, 2020
Small Changes, Big Gains: A Quality Improvement Approach to Increasing Responsive Care for Infants and Toddlers with
Jennifer L Harman1, Alyssa Marchetta2, David Wittman3
1Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Insights
Caregiver psychoeducation significantly improved responsive care for hospitalized infants and toddlers with cancer. This low-cost intervention enhanced patient wellbeing in an oncology setting.
Area of Science:
- Pediatric Oncology
- Developmental Psychology
- Healthcare Quality Improvement
Background:
- Responsive caregiving is crucial for infant and toddler wellbeing.
- Inpatient pediatric oncology patients face unique developmental risks.
- A significant gap existed in observed responsive care for these vulnerable children.
Purpose of the Study:
- To enhance caregiver engagement in responsive interactions for hospitalized infants and toddlers.
- To improve the quality of care for young cancer patients during inpatient stays.
Main Methods:
- Utilized the Model for Improvement framework for a clinical quality improvement project.
- Employed fishbone and key driver diagrams for root cause analysis.
- Tracked outcomes using control charts and statistical process control.
Main Results:
- Two intervention cycles led to significant reductions in observed care gaps.
- Responsive care increased, with fewer nursing shifts lacking caregiver interaction.
- Interventions demonstrated a meaningful positive impact (>1 sigma).
Conclusions:
- Caregiver psychoeducation effectively increased responsive care in pediatric oncology.
- This cost-effective intervention shows potential for broader adaptation in inpatient settings.
- Improved responsive care positively impacts infant and toddler wellbeing.
Background:
Responsive caregiving supports infant and toddler wellbeing. Yet, based on nursing observational data, a significant number of one institution's inpatient infant and toddler patients with cancer-who are uniquely vulnerable due to the developmental risks associated with their illness and treatment-were not spoken to or held by their caregiver at any time when nursing was present over the course of day shifts.
Objective:
This clinical quality improvement project aimed to increase caregiver engagement in responsive interactions during inpatient stays.
Methods:
The Model for Improvement framework was used. Implementation, evaluation, and reporting followed the SQUIRE 2.0 framework. Root causes were analyzed with fishbone and key driver diagrams. Outcomes were tracked with control charts and percentage of nursing shifts during which responsive care was not observed. Statistical process control was used to study interventions.
Results:
Two intervention cycles were completed and resulted in significant and meaningful (>1 sigma) reductions in nursing shifts during which infants and toddlers were not spoken to or held.
Conclusions:
Caregiver psychoeducation interventions increased responsive care of infants and toddlers in our oncology inpatient setting. This low-cost intervention may be adaptable across inpatient settings.
Related Concept Videos
01:13Patient-centered Care
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
01:27Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:25Fundamentals of Nursing Process II
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...